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Sundowning: severe dementia and bringing on the night (weird case)

KP-PC k.p.collins at worldnet.att.net%remove%
Sun Mar 30 05:44:58 EST 2003

This's clearly an instance of 'crossed-up' "supersystem
configuration" [AoK, Ap5] - just the sort of thing that'd result from
the prolonged TD E/I(up)-induced "desynchronization" that I've been
discussing in this thread.

I'll add here that it's actually not an "internal war". What happens
is that, as prolonged TD E/I(up) continues, response latencies within
the TD E/I-minimization mechanisms increase. This leads to the
desynchronization because the various TD E/I-minimization mechanisms
do their own stuff before they receive 'completely' TD E/I-minimized
activation 'states' from the other TD E/I-minimization mechanisms,
and this results in the "supersystem configuration" errors that
inappropriately 'gate' stuff through within the 'momentary'
"supersystem configuration". This results in 'atypical' behavioral
manifestations, which induce 'environment' [including other
interactors] to exert TD E/I(up)-generating 'pressures', which
exacerbates the prolonged TD E/I(up) condition in a way that tends to
further overwhelm the TD E/I-minimization mechanisms, resulting in a
'classic' "viscious cycle".

Within such, the 'inappropriate' TD E/I-minimization that, over the
long term, leads to the observed tissue loss, occurs [which is what I
termed an "internal war" in my prior post in this thread]. [All of
this stuff has been in AoK all along.]

Thanks for the ref, John.

Cheers, ken

"John H." <johnh at faraway.xxx> wrote in message
news:UHxha.136$_3.6448 at nnrp1.ozemail.com.au...
| 30/03/03 6:13pm
| An unusual case of sundown syndrome subsequent to a traumatic head
|   Duckett S Brain Inj 1992 Mar-Apr 6:189-91
| BROWSE: Brain Inj
| Abstract
| An unusual case of sundown syndrome is here reported, in which a
| patient would involuntarily change languages at sunset. Numerous
| have been advanced in attempting to account for sundowning. Cameron
| suggested that nocturnal delirium was based on an inability to
maintain a
| spatial image without the assistance of repeated visualization.
Kral and
| Wolanin and Phillips have argued for a more psychogenic account, by
| that psychosocial stressors may, in concert with impaired cognitive
| functioning, account for sundowning. The present case concerns a
| white male who in January 1989 suffered a closed head injury. A
| personal history as well as a detailed examination of the patient's
| activities allowed us to account for the unusual manner in which
| sundowning manifested itself. The uniqueness of this case allows us
| underscore both the psychological as well as environmental and
| factors involved in sundowning. Thus, we have as a consequence been
able to
| synthesize the seemingly disparate accounts of both Cameron and
more recent
| published literature.
| MeSH
| Top of Form 1
| Adult (); Arousal (); Attention (); Brain Damage, Chronic (); Case
| (); Circadian Rhythm (); Delirium (); Head Injuries, Closed ();
Human ();
| Language (); Male (); Orientation (); Rehabilitation Centers ();
| Environment ()
| Bottom of Form 1

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